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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
M
B
R
E
D
I
V
O
R
P
U
D
S
E
G
R
A
H
C
M
R
B
S
I
A
U
F
Z
E
O
E
O
R
U
I
A
U
Q
F
S
B
D
C
F
V
T
S
G
F
F
I
L
I
E
O
S
I
K
J
N
R
I
L
C
D
F
M
P
B
V
C
O
B
D
A
U
H
P
K
L
S
K
Q
S
T
R
R
G
L
W
B
A
F
L
E
I
E
E
V
Y
U
Y
M
C
K
W
G
S
G
R
S
F
B
R
S
E
V
V
O
H
Z
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